This multiple-Pi, multiple-institution application for the competing renewal of the Pacific Northwest (PNW) Node of the NIDA Clinical Trials Network, submitted jointly by the University of Washington and Washington State University (WSU), has the primary aim of continuing the Node's active support of the CTN's mission to improve the quality of drug abuse treatment throughout the country using science as the vehicle, to conduct studies of the therapeutic effect of behavioral, pharmacological, and combined/integrated treatment interventions in rigorous, multi-site clinical trials to determine effectiveness across a broad range of community-based treatment settings and diversified patient populations, and to ensure the transfer of research results to physicians, clinicians, providers, policy makers, and patients. To meet these objectives, the PNW Node proposes to: 'Maintain/expand the effective, bidirectional partnerships among researchers, substance abuse treatment and healthcare providers, and policy makers that predate our entry into the CTN; 'Maintain/expand our highly successful, well-established treatment research infrastructure; 'Expand the Node's geographical reach, working with the CTSA-funded Institute of Translational Health Sciences (ITHS), to include the WWAMI region (Washington, Wyoming, Alaska, Montana, and Idaho); 'Expand the Node's ethnic and demographic diversity by broadening the types of affiliated programs, expanding our focus on American Indians/Alaska Natives, and concentrating on rural communities/programs through our partnership with WSU's Program of Excellence on Rural Mental Health and Substance Abuse Treatment; Enhance the Node's capacity to conduct trials and respond more rapidly to shifting and emerging public health priorities by adding a number of larger, highly research-experienced, medically and psychiatrically focused partner organizations to complement our affiliated community-based substance abuse treatment programs; 'Augment the clinical research expertise of the Node by adding a number of new affiliated Investigators; 'Expand the Node's network of dissemination partners in order to provide research translation and training to a wider geographic and professional audience of providers, especially in primary care and rural settings. This new structure will allow us to capitalize on progress we have made and will enable us to continue to make significant contributions to the CTN's mission in the future.